Abstract
Advances in arthroscopic technique have allowed a more accurate assessment and classification of the pathological changes in Kienböck’s disease. This assists in decision making and customizing treatment for the individual patient and their wrist disorder. In our practice arthroscopic reconstructive procedures for Kienböck’s disease include lunate excision, proximal row carpectomy and partial wrist fusions. In advanced Kienböck’s disease where the radioscaphoid articulation is still preserved, we utilize scaphocapitate fusion, which bypasses the load to the radioscaphoid articulation, and therefore unloads the lunate. In this article the specific indications and techniques of arthroscopic scaphocapitate fusion, radioscapholunate fusion and proximal row carpectomy are described.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Lichtman DM, Lesley NE, Simmons SP. The classification and treatment of Kienböck’s disease: the state of the art and a look at the future. J Hand Surg Eur Vol. 2010;35:549–54.
Bain GI, Begg M. Arthroscopic assessment and classification of Kienböck’s disease. Tech Hand Up Extrem Surg. 2006;10(1):8–13.
Menth-Chiari WA, Poehling GG, Wiesler ER, Ruch DS. Arthroscopic debridement for the treatment of Kienböck’s disease. Arthroscopy. 1999;15(1):12–9.
Bain GI, Durrant A. An articular-based approach to Kienbock avascular necrosis of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):41–7.
Bain GI, Munt J, Turner PC. New advances in wrist arthroscopy. Arthroscopy. 2008;24(3):355–67.
Ho PC. Arthroscopic partial wrist fusion. Tech Hand Up Extrem Surg. 2008;12(4):242–65.
Ho PC. Arthroscopic partial wrist fusion. In: Geissler WB, editor. Wrist and elbow arthroscopy: a practical surgical guide to techniques. Berlin: Springer; 2014. p. 195–223.
Sutro CJ. Treatment of nonunion of the carpal navicular bone. Surgery. 1946;20:536–40.
Helfet AJ. A new operation for ununited fracture of the scaphoid. J Bone Joint Surg Br. 1952;34:329.
Luegmair M, Saffar P. Scaphocapitate arthrodesis for treatment of late stage Kienbock disease. J Hand Surg Eur Vol. 2014;39(4):416–22.
Pisano SM, Peimer CA, Wheeler DR, Sherwin F. Scaphocapitate intercarpal arthrodesis. J Hand Surg Am. 1991;16(2):328–33.
Garcia-Elias M, Cooney WP, An KN, Linscheid RL, Chao EYS. Wrist kinematics after limited intercarpal arthrodesis. J Hand Surg Am. 1989;14:791–9.
Horii E, Garcia-Elias M, Bishop AT, Cooney WP, Linscheid RL, Chao EY. Effect on force transmission across the carpus in procedures used to treat Kienböck’s disease. J Hand Surg Am. 1990;15:393–400.
Iwasaki N, Genda E, Barrance PJ, Minami A, Kaneda K, Chao EYS. Biomechanical analysis of limited intercarpal fusion for the treatment of Kienböck’s disease: a three-dimensional theoretical study. J Orthop Res. 1998;16:256–63.
Viegas SF, Patterson RM, Peterson PD, Pogue DJ, Jenkins DK, Sweo TD, et al. Evaluation of the biomechanical efficacy of limited intercarpal fusions for the treatment of scapho-lunate dissociation. J Hand Surg Am. 1990;15(1):120–8.
Ho PC. Arthroscopic radiocarpal fusion for post-traumatic radiocarpal arthrosis. In: Pinel FD, Mathoulin C, Luchetti R, editors. Arthroscopic management of distal radius fractures. Berlin: Springer; 2010. p. 225–42.
Minamikawa Y, Peimer CA, Yamaguchi T, Medige J, Sherwin FS. Ideal scaphoid angle for intercarpal arthrodesis. J Hand Surg Am. 1992;17:370–5.
Lee JS, Park MJ, Kang HJ. Scaphotrapeziotrapezoid arthrodesis and lunate excision for advanced Kienböck’s disease. J Hand Surg Am. 2012;37:2226–32.
Matsuhashi T, Iwasaki N, Kato H, Minami M, Minami A. Clinical outcomes of excision arthroplasty for Kienbock’s disease. Hand Surg. 2011;16(3):277–82.
Chim H, Moran SL. Long-term outcomes of proximal row carpectomy: a systematic review of the literature. J Wrist Surg. 2012;1(2):141–8.
Allan CH, Joshi A, Lichtman DM. Kienböck’s disease: diagnosis and treatment. J Am Acad Orthop Surg. 2001;9:128–36.
Beredjiklian PK. Kienböck’s disease. J Hand Surg Am. 2009;34:167–75.
Lutsky K, Beredjiklian PK. Kienböck disease. J Hand Surg Am. 2012;37(9):1942–52.
Iorio ML, Kennedy CD, Huang JI. Limited intercarpal fusion as a salvage procedure for advanced Kienbock disease. Hand. 2015;10:472. doi:10.1007/s11552-014-9705-z.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Examination of soft and fragmented distal lunate cartilage in the mid-carpal joint (MP4 7124 kb)
Lunate excision is performed with an arthroscopic burr within the central of lunate. It is directed radially and then in all directions (MP4 2298 kb)
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Tse, Wl., Teng, X., Liu, B., Wing-yee, C.W., Ho, Pc., Bain, G.I. (2016). Arthroscopic Reconstructive Procedures for Kienböck’s Disease. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_25
Download citation
DOI: https://doi.org/10.1007/978-3-319-34226-9_25
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-34224-5
Online ISBN: 978-3-319-34226-9
eBook Packages: MedicineMedicine (R0)